At Least 50% of Recent Onset Rheumatoid Arthritis Patients Become
Free of Signs and Symptoms Within 36 Weeks

The results of a systematic step-up DMARD treatment schedule in
combination with tight control

PARIS, France, Wednesday June 11th 2008: At least 50% of recent
onset rheumatoid arthritis patients achieve remission (a state free
of signs and symptoms) within 36 weeks when following a systematic
approach of step-up DMARD treatment in combination with tight
control, according to results of a study presented today at EULAR
2008, the Annual Congress of the European League Against Rheumatism
in Paris, France. Results of this study indicate that achieving
remission is not only possible during clinical trials but can be a
realistic goal of standard clinical care.

The researchers achieved these results through implementation of a
tightly regulated DMARD treatment scheme, as follows:

Methotrexate 15mg/week was initiated following diagnosis If
remission was not achieved at week 8, the dose was increased to
25mg/week If not achieved at week 12, sulfasalazine was added
(2grams/day) If not achieved at week 20, the dose was increased to
3grams/day If not achieved at week 24 adalimumab was added to
methotrexate Every 3 months thereafter, therapy could be adjusted
based on DAS28, also using other TNF-blockers. Patients were
allowed to take NSAIDs, and prednisolone ?10mg/day and
intra-articular corticosteroid injections could be administered Dr.
H. Kuper and Prof M. van de Laar of Medisch Spectrum Twente &
University Twente, the Netherlands, who led the study, said; "In
many large clinical trials, remission can be considered a realistic
goal. We set out to determine whether all patients presenting in
daily clinical practice can reasonably expect to achieve a state
free of signs and symptoms, if a strict treatment schedule was
followed. Our results show that remission is indeed achievable in
as many as half of clinical practice patients following this
schedule, which could indicate that remission is a realistic
treatment goal of daily clinical practice."

As part of the Dutch Rheumatoid Arthritis Monitoring Registry
(DREAM), investigators performed a prospective descriptive study of
a cohort of recent onset rheumatoid arthritis DMARD-naïve,
patients in daily clinical practice, between January 2006 and
January 2008. 190 consecutive patients with recently diagnosed RA
under the care of the rheumatology clinics of three hospitals in
the Netherlands were included. Results were taken from the first
169 patients with DAS28>3.2 at inclusion.

At baseline, patient characteristics between the hospitals were
comparable – average patient age was 57.3 years (13.7), 63.9%
were female, 52.7% of which were rheumatoid factor positive, with
an average disease duration of 16 weeks (1-52), ESR 33.2 (20.5),
CRP 23.5 (26.4), DAS28 5.1 (1.1), HAQ 1.3 (0.6).

For further information on this study, or to request an interview
with the study lead, please do not hesitate to contact the EULAR
congress press office on:

The European League Against Rheumatism (EULAR) is the organisation
which represents the patient, health professional and scientific
societies of rheumatology of all the European nations. The aims of
EULAR are to reduce the burden of rheumatic diseases on the
individual and society and to improve the treatment, prevention and
rehabilitation of musculoskeletal diseases. To this end, EULAR
fosters excellence in education and research in the field of
rheumatology. It promotes the translation of research advances into
daily care and fights for the recognition of the needs of people
with musculoskeletal diseases by the governing bodies in Europe.
Diseases of bones and joints, such as rheumatoid arthritis and
osteoarthritis cause disability in 4 - 5 % of the adult population
and are predicted to rise as people live longer. As new treatments
emerge and cellular mechanisms are discovered, EULAR 2008 brings
together more than 12,000 experts - scientists, clinicians,
healthcare workers, pharmaceutical companies and patients - to
share their knowledge in a global endeavour to challenge the pain
and disability caused by musculo-skeletal disorders. To find out
more information about the activities of EULAR, visit:
www.eular.org